|Publication number||US3939497 A|
|Application number||US 05/530,553|
|Publication date||Feb 24, 1976|
|Filing date||Dec 9, 1974|
|Priority date||Dec 28, 1973|
|Also published as||DE2365022A1, DE2365022B1|
|Publication number||05530553, 530553, US 3939497 A, US 3939497A, US-A-3939497, US3939497 A, US3939497A|
|Inventors||Gunther Heimke, Peter Griss, Hanns Von Andrian-Werburg, Herbert Heil, Paul Wachter|
|Original Assignee||Friedrichsfeld Gmbh. Steinzeug-Und Kunststoffwerke|
|Export Citation||BiBTeX, EndNote, RefMan|
|Patent Citations (2), Referenced by (60), Classifications (37)|
|External Links: USPTO, USPTO Assignment, Espacenet|
This invention relates to the socket part of a total hip joint prosthesis, that is to say to that part of the prosthesis which is inserted into the hip bone amd more particularly, to the case in which the insertion of the prosthesis into the hip bone takes place without the use of a bone cement. For implantation without the use of a cement, only those parts of a prosthesis which consist of a bio-inert raw material are involved, which permits the intimate and mechanically firm growing of the bone tissue onto the surface of the prosthesis at the places provided therefor. Therefore, the invention relates to sockets for total hip joint prostheses made of a biologically-inert material, especially of a dense Al2 O3 ceramic.
Hitherto total hip joint prostheses were attached in orthopedic surgery essentially with the aid of plastic bone cement in the bone cavities adjoining the joint. This technique has been used for about 10 years to a large and continuously growing extent. However, it has turned out, that the use of plastic bone cement leads to various complications. The possibility of cement free implantation of the two parts of a hip joint prosthesis, namely of the socket part to be attached in the hip bone and the thigh part attached in the femur, therefore represents an essential and significant progress.
The customary and hitherto available sockets for hip joint full prostheses for implantation with the aid of bone cement cannot be adapted easily for the cement free implantation, since a certain time in the order of magnitude of 1-3 months is needed for the growing in or growing on of the tissue to the surface of the prosthesis. During this time, a relative movement between the bone tissue and the socket must be avoided. However, this avoidance of relative movements between the bone tissue and the side of the socket facing it has not been ensured in the case of these former socket constructions.
Socket constructions have already been proposed, made of aluminum oxide ceramic in a dense and/or porous form, or with a porous layer on the surface facing the bone, which are intended for a cement free implantation (German published application No. 2,134,316). It turns out however, that such sockets are not protected sufficiently against twisting.
Socket constructions for cement free implantation have also already been proposed, which have a protection against twisting and which in their entirety, consist of a raw material, which makes possible a mechanically firm growing on of the bone tissue to the surface of the prosthesis. In the copending application corresponding to German application No. 2314175, a socket for hip joint prosthesis made of aluminum oxide ceramic which can be screwed in, has been described. While this latter prosthesis represents an advance as compared to the then status of the prior art, since by screwing in with a partially self-tapping thread and with the attachment of additional protection against twisting, a stable seat of the socket immediately after the operation is assured, yet the expense in the use of this socket is quite high, because of the necessity of precutting of the thread and predrilling of the holes for the twist prevention.
A socket part of a full hip joint prosthesis has also been proposed in which case the twist prevention is given by the angular shape of the side of the socket facing the hip bone (copending application corresponding to German application No. 2325585). In that case, a socket made of Al2 03 ceramic, it is true that the necessary instruments needed for threading and predrilling of the holes serving for prevention of twisting is no longer necessary and a number of operations are saved during implantation. Nevertheless, it turned out that it is quite difficult to achieve, under the conditions of the operation, a high degree of precision in chiselling the shape of the angular socket out of the hip bone, which is required for a firm solid seat for the socket.
The socket, according to the present invention, for hip joint prostheses for cement free implantation, results in a further simplification of the technique of the operation and thus constitutes a notable advance, as compared to the hitherto known socket constructions.
FIGS. 1 and 1A are plan, and elevational, views of a preferred socket;
FIGS. 2 and 2A are elevational, and plan, views of an implanting tool, and
FIG. 3 shows another such tool.
In FIGS. 1 and 1A of the drawings, the reference numeral 1 represents the essential cylindrical body of the socket in its outside contour. In it, an approximately semispherical cavity 2, is provided in one of its two sides in which the head of the femur part of the hip joint prosthesis is mounted after insertion. The socket in its center is provided with two concentric bores having variable diameters 7 and 8, with a tapered shoulder 9 between them into which the screw 3 fits. The screw 3 at its lower end has a thread 4. The body 1 of the socket contains bores which are designated by numeral 5. The pegs 6 are mounted in them.
The procedure for the implantation of the hip joint socket according to the invention is as follows: First of all, the implantation space in the hip bone is preshaped with a rasp 10 as shown in FIGS. 2 and 2A, which is similar to a cutter head. The outside diameter of this cutter head 11 corresponds to the outside diameter of the socket 1. Subsequently the hollow space needed for the socket is finished in the hip joint bone with an instrument 20, having a hollow cutter 21 to make the space cylindrical as shown in FIG. 3. Finally, the hole needed for the central screw 3 in socket 1 is drilled in the center by means of a drill limited correspondingly in its drilling depth to such a point, that the thread 4 can later penetrate in a self-tapping manner.
During insertion of the socket, the screw 3 is in an unscrewed state to such a point that the peg 6 will be in contact with the lower course of the thread 4 in the lower part of the screw 3. This portion of the screw 3, carrying the thread, has a smaller diameter than its upper part, so that the pointed inner ends of the pegs 6 upon engagement with the turns of the thread 4, do not project from the sides of the body 1 of the socket. In order to make possible the engagement of the inner pointed ends of the pegs 6 in the lowest turn of the thread 4 on screw 3, the bores in which the pegs 6 are guided, are displaced radially outwardly into the surrounding bone tissue. As drawn in FIG. 1, three pegs are arranged radially and the corresponding bores are displaced by 120° and are differentiated as to their height in each case by one third of the height of the pitch of the thread. After insertion of the socket, the screw 3 is screwed in with a screwdriver. In the case of this screwdriver, the part touching the screw, and preferably the socket, is covered with plastic in order to avoid metal abrasion of the socket or its parts. During this screwing in of the screw 3, the pegs 6 first serve for the guidance of the screw and they constitute the support for driving them in. After penetration of the screw 3 into the corresponding predrilled part of the hip bone, the thread is tapped there automatically in the same way a wood screw acts. At the same time, the pegs 6 are forced apart because of the ending of thread 4 and by contact with the tapered shoulder defined by the transition part of the screw 3 between the area of smaller diameter to the superposed part of larger diameter. The pointed ends of the pegs 6 directed outwardly at the same time penetrate the hip bone and lead to the necessary firm and twistproof anchoring of the socket in the hip bone. Also, as the screw moves down, the tapered shoulder meets the shoulder 9 defining the transition between the two bores 7 and 8, which assists in retaining the socket in place.
With this implantion technique, which is made possible by the socket according to the invention, there is achieved with a few manipulations, a mechanically firm and twistproof seat for the socket. At the same time, there is no great requirement for precision to be made for the preliminary work of drilling out the space in the hip bone required for the socket, so that an efficient procedure is also possible for these preparatory operations. However, the saving of time in such a serious operation as represented by the insertion of a total hip joint prosthesis, is a decisive factor and constitutes an essential criterion for the useability of an implant.
The preferred material for a socket for total hip joint prostheses according to the invention consists of a raw material which permits the mechanically firm adhesion, or growing on, of bone tissue to the surface of the implant. Preferably, all individual parts of the socket, according to the invention, are made of the same raw material. The mechanically tight and firm "growing on" of bone tissue exists particularly in the case of aluminum oxide ceramic. Some glass ceramic types also fulfill this condition. However, aluminum oxide ceramic, because of its other mechanical characteristics, especially because of its high wear resistance, is preferred for this use. By aluminum oxide ceramic, one understands a ceramic material, which consists of more than 85 percent of aluminum oxide. For hip joint prostheses and the sockets according to the invention, an aluminum oxide ceramic with more than 96 percent Al2 03 is preferred. A highly corrosion resistant and a highly wear resistant aluminum oxide ceramic with more than 99 percent aluminum oxide contents is particularly favorable. These materials are used in a state sintered to high density, that is to say, having a density of at least 90 percent, preferably 95 percent of the theoretical density of the material used.
|Cited Patent||Filing date||Publication date||Applicant||Title|
|US2857670 *||Apr 16, 1956||Oct 28, 1958||Kiernan Jr Thomas F||Individual tooth implant|
|FR2096895A1 *||Title not available|
|Citing Patent||Filing date||Publication date||Applicant||Title|
|US4551863 *||Feb 4, 1985||Nov 12, 1985||Murray William M||Femoral component and method|
|US4599086 *||Jun 7, 1985||Jul 8, 1986||Doty James R||Spine stabilization device and method|
|US4878918 *||Nov 5, 1985||Nov 7, 1989||Gabor Tari||Mechanically fixed acetabular unit for prostheses and implantation device for fixing it into the cotyloid cavity|
|US5180383 *||Oct 9, 1991||Jan 19, 1993||Haydon Frank A||Method and device for attaching artificial joint implants to the ends of bones|
|US5226917 *||Feb 14, 1991||Jul 13, 1993||Smith & Nephew Richards Inc.||Acetabular prosthesis with anchoring pegs|
|US5310408 *||Aug 31, 1992||May 10, 1994||Smith & Nephew Richards Inc.||Acetabular cup body prosthesis|
|US5314487 *||Feb 10, 1992||May 24, 1994||Smith & Nephew Richards Inc.||Acetabular prosthesis with anchoring pegs|
|US5338771 *||Nov 28, 1990||Aug 16, 1994||Eska Medical Luebeck Medizin Technik Gmbh||Joint endoprosthesis with Al2 O3 ceramic head and a composite socket and process for making it|
|US5676704 *||Nov 27, 1995||Oct 14, 1997||Smith & Nephew, Inc.||Acetabular cup body prosthesis|
|US5702481 *||May 16, 1995||Dec 30, 1997||Lin; Chih-I||Bone marrow cavity fixation device for treating a fractured bone|
|US5782928 *||Oct 23, 1996||Jul 21, 1998||Smith & Nephew, Inc.||Acetabular cup body prosthesis|
|US5879405 *||May 23, 1997||Mar 9, 1999||Smith & Nephew, Inc.||Acetabular cup body prosthesis|
|US6179839 *||Sep 20, 1999||Jan 30, 2001||Kinetikos Medical Incorporated||Bone fusion apparatus and method|
|US7090676||Nov 19, 2003||Aug 15, 2006||Acumed Llc||Adjustable bone plates|
|US7153309||Nov 19, 2003||Dec 26, 2006||Acumed Llc||Guide system for bone-repair devices|
|US7189237||Nov 19, 2003||Mar 13, 2007||Acumed Llc||Deformable bone plates|
|US7326212||Nov 19, 2003||Feb 5, 2008||Acumed Llc||Bone plates with reference marks|
|US7537596||Jun 21, 2004||May 26, 2009||Acumed Llc||Bone plates with intraoperatively tapped apertures|
|US7537603||Jul 22, 2003||May 26, 2009||Acumed Llc||Bone fusion system|
|US7537604||Nov 19, 2003||May 26, 2009||Acumed Llc||Bone plates with slots|
|US7578825||Apr 19, 2005||Aug 25, 2009||Acumed Llc||Placement of fasteners into bone|
|US7635365||Aug 27, 2004||Dec 22, 2009||Ellis Thomas J||Bone plates|
|US7695501||Jun 16, 2006||Apr 13, 2010||Ellis Thomas J||Bone fixation system|
|US7704251||Aug 14, 2006||Apr 27, 2010||Acumed Llc||Adjustable bone plates|
|US7717945||Dec 11, 2006||May 18, 2010||Acumed Llc||Orthopedic systems|
|US8177819||May 15, 2012||Acumed Llc||Expanded fixation of bones|
|US8425574||Feb 16, 2011||Apr 23, 2013||Acumed, Llc||Bone fixation with a bone plate attached to a fastener assembly|
|US8556984 *||Jun 7, 2004||Oct 15, 2013||Biotechni||Insert for a cotyloid implant cup for a joint prosthesis, cotyloid implant and joint prosthesis|
|US8568417||Sep 20, 2010||Oct 29, 2013||Charles River Engineering Solutions And Technologies, Llc||Articulating tool and methods of using|
|US8579985 *||Dec 22, 2011||Nov 12, 2013||Ihip Surgical, Llc||Method and apparatus for hip replacement|
|US8632573||Apr 13, 2010||Jan 21, 2014||Thomas J. Ellis||Bone fixation system|
|US8795381||May 14, 2012||Aug 5, 2014||Ihip Surgical, Llc||Methods and systems for hip replacement|
|US8900321||Mar 19, 2007||Dec 2, 2014||Zimmer, Inc.||Implant anchoring device|
|US8974540||Mar 12, 2013||Mar 10, 2015||Ihip Surgical, Llc||Method and apparatus for attachment in a modular hip replacement or fracture fixation device|
|US9237910||Jan 28, 2013||Jan 19, 2016||Acute Innovations Llc||Clip for rib stabilization|
|US9237949||Nov 11, 2013||Jan 19, 2016||Ihip Surgical, Llc||Method and apparatus for hip replacement|
|US9308033||Apr 13, 2015||Apr 12, 2016||Acumed Llc||Adjustable bone plates|
|US20040102778 *||Nov 19, 2003||May 27, 2004||Huebner Randall J.||Adjustable bone plates|
|US20040102788 *||Nov 19, 2003||May 27, 2004||Huebner Randall J.||Guide system for bone-repair devices|
|US20040116930 *||Dec 8, 2003||Jun 17, 2004||O'driscoll Shawn W.||Bone plates|
|US20040260291 *||Jun 21, 2004||Dec 23, 2004||Jensen David G.||Bone plates with intraoperatively tapped apertures|
|US20050085819 *||Aug 27, 2004||Apr 21, 2005||Ellis Thomas J.||Bone plates|
|US20050131413 *||Jun 21, 2004||Jun 16, 2005||O'driscoll Shawn W.||Bone plate with interference fit screw|
|US20050171544 *||Feb 2, 2005||Aug 4, 2005||Acumed Llc||Bone plate with toothed aperture|
|US20050234458 *||Apr 19, 2005||Oct 20, 2005||Huebner Randall J||Expanded stabilization of bones|
|US20050234472 *||Apr 19, 2005||Oct 20, 2005||Huebner Randall J||Placement of fasteners into bone|
|US20050240187 *||Apr 22, 2005||Oct 27, 2005||Huebner Randall J||Expanded fixation of bones|
|US20060276905 *||Jun 7, 2004||Dec 7, 2006||Biotechni||Insert for a cotyloid implant cup for a joint prosthesis, cotyloid implant and joint prosthesis|
|US20070055249 *||Jun 7, 2006||Mar 8, 2007||Jensen David G||Bone plates with intraoperatively tapped apertures|
|US20070162018 *||Dec 11, 2006||Jul 12, 2007||Jensen David G||Orthopedic systems|
|US20070276405 *||Aug 14, 2006||Nov 29, 2007||Huebner Randall J||Adjustable bone plates|
|US20080046091 *||Mar 19, 2007||Feb 21, 2008||Zimmer Technology, Inc.||Implant anchoring device|
|US20090069812 *||Jun 16, 2008||Mar 12, 2009||Acumed Llc||Rib fixation with an intramedullary nail|
|US20110137351 *||Jun 9, 2011||Acumed Llc||Bone fixation with a bone plate attached to a fastener assembly|
|US20110152867 *||Jun 23, 2011||Joseph Petrzelka||Articulating Tool and Methods of Using|
|US20120130502 *||May 24, 2012||Ihip Surgical, Llc||Method and apparatus for hip replacement|
|EP0879577A2 *||Apr 2, 1998||Nov 25, 1998||Precifar S.A.||Milling cutter for medical purposes|
|WO1998015240A1||Oct 1, 1997||Apr 16, 1998||Smith & Nephew, Inc.||Acetabular ring prosthesis with reinforcement buttress|
|WO1998017206A1||May 23, 1997||Apr 30, 1998||Smith & Nephew Inc.||Acetabular cup body prosthesis|
|WO2001021083A1 *||Sep 20, 2000||Mar 29, 2001||Kinetikos Medical Incorporated||Bone fusion apparatus and method|
|U.S. Classification||623/22.36, 606/310, 606/312, 623/22.37|
|International Classification||A61F2/36, A61B17/16, A61F2/34, A61F2/38, A61F2/00, A61F2/32, A61F2/30|
|Cooperative Classification||A61F2002/30823, A61L2430/24, A61F2002/30929, A61F2310/00934, A61F2310/00203, A61F2/30907, A61F2/32, A61F2310/00928, A61F2310/00017, A61F2002/30158, A61F2/34, A61F2310/00592, A61F2002/3631, A61F2002/3085, A61F2/3804, A61F2/36, A61F2002/365, A61B17/1666, A61F2230/0026, A61F2/3609, A61F2002/3403|
|European Classification||A61B17/16S2C, A61F2/36, A61F2/34, A61F2/30L4, A61F2/38B|